A screening test is done to find possible health problems or diseases in people who don't have any symptoms. The goal is to find a disease early so lifestyle changes can be made and you can be watched more closely to lower the risk of disease, or to find it early enough to treat it most effectively. Screening tests are not diagnostic. But they are used to find out if more testing is needed. Health counseling is vital, too. This plan does not include recommendations for pregnancy. You and your healthcare provider may decide that a different schedule is best for you. But this plan can guide your discussion.
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Screening
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Who needs it
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How often
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Type 2 diabetes or prediabetes
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All adults starting at age 45 and adults with no symptoms at any age who are overweight or obese and have 1 or more additional risk factors for diabetes
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At least every 3 years
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Alcohol misuse
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All adults
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At routine exams
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Blood pressure
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All adults
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Yearly checkup if your blood pressure is normal.
Normal blood pressure is less than 120/80 mmHg.1
If your blood pressure reading is higher than normal, follow the advice of your healthcare provider.
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Breast cancer
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All women2
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Screening with a mammogram every year is an option starting at age 40. Talk to your healthcare provider regarding your recommended frequency depending on your risk factors.
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Cervical cancer
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All women, except those who had a hysterectomy (with removal of the cervix) for reasons not related to cervical cancer and no history of cervical cancer or serious precancer
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Women between the ages of 30 and 65 should have a Pap test plus an HPV test (called "co-testing") every 5 years. This is the preferred approach. But it is also acceptable to continue to have Pap tests alone every 3 years.
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Colorectal cancer
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Women of average risk ages 45 years and older
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Several tests are available and used at different times.
Tests include:
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Flexible sigmoidoscopy every 5 years, or
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CT colonography (virtual colonoscopy) every 5 years, or
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Colonoscopy every 10 years, or
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Yearly fecal occult blood test, or
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Yearly fecal immunochemical test every year, or
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Stool DNA test, every 3 years
You will need a follow-up colonoscopy if you choose any test other than a colonoscopy and you have an abnormal result. Screening recommendations vary among expert groups. Talk with your doctor about which test is best for you.
Some people should be screened using a different schedule because of their personal or family history. Talk with your doctor about your health history and what colorectal cancer screening schedule is best for you.
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Chlamydia
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Women at a higher risk for infection
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At routine exams if at risk
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Depression
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All adults in clinical practices that have staff and systems in place to assure accurate diagnosis, effective treatment, and follow-up
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At routine exams
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Gonorrhea
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Sexually active women at a higher risk for infection
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At routine exams if at risk
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Hepatitis C
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Adults at a higher risk; 1 time for those born between 1945 and 1965
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At routine exams if at risk
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HIV
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All women
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At routine exams
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Lipid disorders
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All women age 45 and older at a higher risk for coronary artery disease
For women ages 19 to 44, screening should be based on risk factors; talk with your healthcare provider
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At least every 5 years
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Obesity
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All adults
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At routine checkups
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Syphilis
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Women at a higher risk for infection
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At routine exams if at risk
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Tuberculosis
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Adults at a higher risk for infection
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Check with your healthcare provider.
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Vision
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All adults3
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Baseline comprehensive exam at age 40; if you have a chronic disease, check with your healthcare provider for exam frequency.
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Counseling
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Who needs it
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How often
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Breast cancer, chemoprevention
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Women at high risk
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When risk is identified
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BRCA mutation testing for breast and ovarian cancer susceptibility
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Women with a higher risk
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When risk is identified
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Diet and exercise
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Adults who are overweight or obese
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When diagnosed and at routine exams
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Domestic violence
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Women of child-bearing age and older women with a higher risk
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At routine exams
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Sexually transmitted disease prevention
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Adults at a higher risk for infection
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At routine exams
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Tobacco use and tobacco-related disease
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All adults
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Every exam
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Immunization
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Who needs it
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How often
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Tetanus/diphtheria/pertussis (Td/Tdap) booster
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All adults
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Td: every 10 years
Tdap: substitute a one-time dose of Tdap for a Td booster after age 18, then boost with Td every 10 years
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Chickenpox (varicella)
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All adults in this age group who have no record of previous infection or vaccinations
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2 doses; the second dose should be given at least 4 weeks after the first dose
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Measles, mumps, rubella (MMR)
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All adults in this age group who have no record of previous infection or vaccinations
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1 or 2 doses
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Flu vaccine (seasonal)
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All adults
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Yearly, when the vaccine becomes available in the community
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Hepatitis A vaccine
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People at risk4
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2 doses given 6 months apart
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Hepatitis B vaccine
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People at risk5
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3 doses; the second dose should be given 1 month after the first dose; the third dose should be given at least 2 months after the second dose (and at least 4 months after the first dose).
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Haemophilus influenzae type B (HIB)
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People at risk
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1 to 3 doses
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Meningococcal
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People at risk**
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1 or 2 doses
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Pneumococcal conjugate vaccine (PCV13) and pneumococcal polysaccharide vaccine (PPSV23)
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People at risk
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1 or 2 doses
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1 American College of Cardiology and the American Heart Association Task Force on Clinical Practice Guidelines
5 Exceptions may exist. Please talk with your healthcare provider.